Parenting Stress In Parent-Child Interaction Therapy-Emotion Development

Amanda Pawlikowski and Rayna Rodriguez

Abstract:
Introduction: Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) is an evidence-based approach to treat preschoolers' depressive symptoms by improving caregivers' relationships with their children. The therapist observes caregiver-child interactions via a one-way mirror, and uses a walkie-talkie to coach. There are two types of coaching in PCIT-ED: directive and responsive. Directive coaching is when the therapist gives a direction about the caregiver's future actions, such as suggesting what the caregiver can do or say (indirect commands) or modeling (telling the caregiver exactly what to say). Responsive coaching is when the therapist describes or praises a caregiver's past actions. This study examined the relationships between caregivers' stress levels and the type of coaching therapists use in PCIT-ED.

Method: Participants included 119 families in a randomized controlled trial of PCIT-ED. The children were predominantly White (77%) and male (65%), with an average age of 5.4 years. Caregivers' stress was measured through the Parenting Stress Index (PSI), a self-report scale that includes a Child domain and a Parent domain. The Therapist-Parent Interaction Coding System (TPICS) was used to transcribe and code the therapist's coaching feedback to caregivers.

Results: Caregivers who reported more child-driven stress received more directive coaching, r(119) = .24, p = .01, including more modeling, r(119 ) = .25, p = .007 and more indirect commands, r(119) = .21, p = .022.

Conclusions: Unlike responsive coaching, directive coaching has not been linked to positive treatment outcomes. It is important to continue research on family factors that may be linked to different styles of therapist-family interactions.